iSun
Sunil J Wimalawansa, MD, PhD, MBA, DSc.
Professor of Medicine
Why social distancing of 2-meters will not work:
Imposing social distancing are essential but that is only one part that efforts needed to prevent the disease. Nevertheless, COVID-19 spreads mostly via air through aerosolized particles, people who are getting infected may not even have a clue how they got it. For example, many are known to denies having any close contact with a person with COVID-19 or someone vigorously coughing.
It is the contaminated air that transmit the virus from person to a person. For example, a person can get infected while travelling in buses or in a room, up to 30-feet away from a patient who is coughing. The lack of understanding of this concept has serious repercussions.
In addition, the virus thrives in cold and damp conditions, including in air-conditioning systems. So, in the absence of installed HEPA filters as we discussed in the previous article, the majority of current air-conditioning systems can spread the COVID-19 across an entire building, exposing hundreds of people staying far away.
Irrespective of the way achieving social distancing, the said-gold standard of staying 2-meters away from an infected person, will not prevent others getting infected with COVID-19 or any other respiratory viruses. This is a narrow-minded view of, putting all eggs in one basket to protect them. However, that does not mean, imposing social distancing is less important. However, for it to be successful, it must be combined with several other cost-effective public health principles and preventive actions. Unfortunately, such is not-happening in many countries. We will address these in another article. Nevertheless, it is essential that all countries to work diligently and in cooperation, including sharing information, and taking effective measures to control and eliminate the COVID-epidemic at earliest possible.
Proper use of PCR testing:
Another aspect to worry about is the prematurely release of people from quarantine centres. The only way to prevent this is to test people prior to their discharge on day 14 and then another mandatory PCR testing on day 18. Despite assurances, a significant proportion of people forced to get admitted to the quarantine centres are getting infected from others, due to the insufficient segregation facilities.
Some of them get infected halfway through their stay in these centres, form new entrants with the disease. Therefore, these people although are infected, may not have symptom and too early to become PCR positive. Testing twice on the same day or on a consecutive day in incorrect and is a waste of resources.
Safe use of public places:
Similar to premature discharges from quarantine centres, premature relaxation of social distancing regulations is also a concern. The latter includes, opening up beaches, gymnasium and pubs, hair-saloons, and other places of gathering. Unless done stepwise based on data, such can add another dimension to the ongoing disaster and can be asking for trouble.
In late March, China opened up beaches to the public. Thousands of people gathered at beaches, so as in Florida, Carolina, and California, in recent days. That does not mean beaches and shopping malls should not be open, but it should be done systematically with public education. One must balance the COVID concerns against the multiple beneficial effects for people in participating in outdoor activities. Principally, relaxation of social Distancing must be based on available of reliable data analysis based on community PCR and antibody testing linked to real-time GIS system, and implemented gradually one sector at a time. However, not based on misleading hospital-based PCR testing data which provide no worthwhile information on community infection.
Successfully ingredients in controlling the e pandemic:
The success mostly depends on early identification of affected by PCR testing, humane effective quarantining preferably at self-isolation in their own homes, contact tracing, and taking several other affirmative steps to prevent dissemination of the disease. Most certainly not by locking down province or imposing curfews alone or by punishing people. These are worthless draconian measures.
Other success factors include, extensive testing outside of hospital systems, effective surveillance, taking firm actions, and public education of social distancing, implementing strict hygienic measures, effective and diligent contact tracing and testing, and humane quarantining to prevent further spread. Finally, the most important is to apply the principles that we learned from 2002 SARS crisis and the first few months of the COVID-19 pandemic and not listening to the theoretical pundits.
Following the above made it easier for leaders of eastern countries to implement a tailor-made package of items simultaneously; this is what other countries should follow. Blindly following the failed most western and few eastern models or action by police, military or controlling political leaders based on gut-feeling would continue to fail.
Mentioned eastern countries had a major advantage because of the previous experience with SARS epidemic in 2002. This allow better prepare not only for the government but also the public. They knew exactly what to do and fully cooperated with administrations on doing right things. As in Hong Kong and south Korea, wearing a face mask in public is the norm and is designed to protect themselves.
The next article discusses key successful actions taken by different countries and successful outcome, and why some western countries failed to control the COVID-19 pandemic.
Comments
Post a Comment